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As the use of assisted reproductive technologies has increased, so, too, has the concern over its effects on the female reproductive system. Specifically, the increased gonadotrophin levels in ovarian cancer pathogenesis coupled with the multiple ovarian punctures and repeated ovarian stimulation associated with in vitro fertilization have raised concerns that IVF may increase the risk of ovarian malignancies.

A 35 year old patient presents with a high grade squamous intraepithelial lesion (HGSIL) Pap smear. There is an unsatisfactory colposcopy; the transformation zone was not sampled. The biopsy shows slight atypia. What’s your next move?

PCOS is a metabolic disorder that affects 5 – 7.5% of all women. It is the number one cause of infertility and if left untreated, can increase risk of endometrial cancer. In addition, women with PCOS are at a greater risk for heart disease and diabetes.

By John C. Jarrett, M.D. and Deidra T. Rausch, Ph.D.

One of the problems with sonography of the early pregnancy is the inability to clearly determine if the gestation sac is intrauterine or extrauterine (ectopic) in nature. This task is even more complicated by the controversies arising from whether the “sac” seen is a true sac or a pseudosac of ectopic pregnancy.

A lactation aid is a device which allows a breastfeeding mother to supplement her baby with expressed breastmilk, formula or glucose water with added colostrum (glucose water alone should only be used, in general, in the first day or two after birth) without using an artificial nipple.

Breastfeeding mothers frequently ask how to know their babies are getting enough milk. The breast is not the bottle, and it is not possible to hold the breast up to the light to see how many ounces or millilitres of milk the baby drank.

Sore nipples are usually due to one or both of two causes. Either the baby is not positioned and latched properly, or the baby is not suckling properly, or both. Incidentally, babies learn to suck properly by getting milk from the breast when they are latched on well.

Colic is one of the mysteries of nature. Nobody knows what it really is, but everyone has an opinion. In the typical situation, the baby starts to have crying periods about two to three weeks after birth.

by Joan Marie Butler, RNC,

Third Revised Editionby Kathleen Huggins,R.N., M.S.

There is no substance that can come close to human milk. Infant formula, a synthetic human milk substitute, is not a healthy alternative to mother's milk. Formula is missing over 400 ingredients present in human milk, which cannot be duplicated by scientists in a laboratory.

For many years I too had advised that the proper way to perform Kegel exercises was to activate those pelvic floor muscles that would allow the patient to stop and then start the urinary stream.

Sometimes it seems that the best science results come from keen observation rather than factual knowledge or experimentation. You remember the story of Jenner, don't you? He observed that milkmaids who contracted cowpox seemed not to become infected with smallpox.

Do pregnancy and childbirth affect bladder control? Yes. But don't panic. If you lose bladder control after childbirth, the problem often goes away by itself. Your muscles may just need time to recover.

Planning to start a family is an exciting time. Many women and their partners wonder if there is anything they can do to help make this both successful and safe. In fact there are many things that can be done to increase the chances of a healthy mother and baby.

In order to stimulate an adequate milk supply, newborns need to nurse a minimum of eight times, and optimally ten to twelve times or more during a twenty-four hour period.

You and your baby have been happily nursing for several months. You have overcome the common problems nursing couples have in the early weeks, such as sore nipples or engorgement, and things are progressing nicely.

Many babies switch forth effortlessly between breast and bottle from day one. Others become “nipple confused” if artificial nipples are introduced during the early days of nursing.

Candida (also called yeast, or thrush) is a fungus that occurs naturally in the mucous membranes and on the skin. Use of antibiotics promotes the overgrowth of yeast by killing off the ‘good’ bacteria that normally keep the yeast from multiplying too quickly.

Breast fullness is a normal part of lactation which nearly all women experience when their milk comes in 2 – 5 days after birth.

There may be times when, for a variety of reasons, nursing mothers need or want to leave their nursing baby with a caregiver. This may be a ‘once only’ event, or a regular daily arrangement.

Breastfeeding is the natural, physiologic way of feeding infants and young children milk, and human milk is the milk made specifically for human infants.

Breastfeeding is as good as combined contraceptive pills (about 2% failure rate) if all the following conditions apply (no exceptions):

Breastfeeding is the natural, physiologic way of feeding infants and young children milk, and human milk is the milk made specifically for human infants.

Severe engorgement about the third or fourth day after the baby is born can usually be prevented by getting the baby latched on well and drinking well from the very beginning. If you do become engorged, please understand that engorgement diminishes within 1 or 2 days even without any treatment.

Mastitis needs to be differentiated from a plugged or blocked duct, because the latter does not need to be treated with antibiotics, whereas mastitis often, but not always, does require treatment with antibiotics.

Because more and more women are now breastfeeding their babies, more and more are also finding that they enjoy breastfeeding enough to want to continue longer than the usual few months they initially thought they would do it.